Archive for Health

Many factors go into the making of an American criminal, but who would have thought that one of them might be lead?

A recent investigative piece by Mother Jones reporter Kevin Drum asserts just that, and it has sparked a wild flurry of debate in the wake of his extensive and damning article.

We all know that many childhood factors can influence a tendency towards crime. Broken homes, exposure to additive substances and many more are often trotted out, and rightfully so. Drum asserts that the ambient lead caused by lead paint and vehicle exhaust are directly linked to crime rates.

Jessica Reyes, public health policy professor at Amherst, weighs in on the research she did, inspired by being pregnant in a old house and learning about the dangers of lead. What Nevin found on the grand scale she found to also hold true on a more granular level (reporting via Mother Jones) :

If childhood lead exposure really did produce criminal behavior in adults, you’d expect that in states where consumption of leaded gasoline declined slowly, crime would decline slowly too. Conversely, in states where it declined quickly, crime would decline quickly. And that’s exactly what she found.

Meanwhile, Nevin had kept busy as well, and in 2007 he published a new paper looking at crime trends around the world (PDF). This way he could make sure the close match he’d found between the lead curve and the crime curve wasn’t just a coincidence. Sure, maybe the real culprit in the United States was something else happening at the exact same time, but what are the odds of that same something happening at several different times in several countries?

Nevin collected lead data and crime data for Australia and found a close match. Ditto for Canada, Great Britain, Finland, France, Italy, New Zealand and West Germany. Every time the two curves fit each other astonishingly well. When I spoke to Nevin about this, I asked him if he had ever found a country that didn’t fit the theory. “No,” he replied. “Not one.”

Just this year, Tulane University researcher Howard Mielke published a paper with demographer Sammy Zahran on the correlation of lead and crime at the city level. They studied six US cities that had both good crime data and good lead data going back to the ’50s, and they found a good fit in every single one. In fact, Mielke has even studied lead concentrations at the neighborhood level in New Orleans and shared his maps with the local police. “When they overlay them with crime maps,” he told me, “they realize they match up.”

As New Orleans native I can tell you that the maps comparing crime and lead here in the Crescent City are so accurate that it is spooky.

Down under in Australia, researchers are finding almost identical results. ABC News Australia covered this as recently as Tuesday, April 9th when they published the following:

Professor Mark Taylor, an environmental scientist at Macquarie University, has now begun Australia’s first study comparing suburbs with high lead air pollution levels and local crime rates.

Professor Taylor says his research also indicates there is close to a 20-year time lag between the peaks in lead air pollution and peaks in the rates of assault.

Boolaroo: Lead air pollution peaked in 1988. The assault rate peaked 21 years later in 2009.

Earlwood, Sydney: Lead air pollution peaked in 1982. The assault rate peaked 20 years later in 2002.

Port Kembla: Lead air pollution peaked in 1979. The assault rate peaked 20 years later in 1999.

Lane Cove, Sydney: Lead air pollution peaked in 1978. The assault rate peaked 21 years later in 1999.

‘The locations we are looking at are, for example, Sydney, Rozelle, Earlwood, Boolaroo, the old lead smelter, Port Kembla as well, so we have been able to extract reasonably good records for those locations,’ he said.

‘We are not saying that it’s a one-to-one relationship; what we are saying is that lead exposure is associated with violent activity.’

The evidence just seems to keep piling up. While correlation does not denote causation, the correlations here seem to be almost universal. Here are a few links that provide a range of additional info on the subject.

Lead and Crime: A Linkfest – Drum has collected an index of all his recent work on this topic. I highly advise this as a starting point.

Lead and Crime: Plumb Crazy – The Economist reminds us that even if we reduce the lead in fuel it is incredibly well entrenched in other places.

Lead and Crime: SkepticBlog – Steven Novella points out some of the possible flaws in Drum’s work, but closes by noting “The research is remarkably consistent in pointing to a real role for lead exposure.”

Forbes, however, has done the best job of succinctly explaining why Drum’s theories hold the ring of truth:

There are three basic reasons why this theory should be believed. First, as Drum points out, the numbers correlate almost perfectly. ‘If you add a lag time of 23 years,’ he writes. ‘Lead emissions from automobiles explain 90 percent of the variation in violent crime in America. Toddlers who ingested high levels of lead in the ’40s and ’50s really were more likely to become violent criminals in the ’60s, ’70s, and ’80s.’

Second, this correlation holds true with no exceptions. Every country studied has shown this same strong correlation between leaded gasoline and violent crime rates. Within the United States, you can see the data at the state level. Where lead concentrations declined quickly, crime declined quickly. Where it declined slowly, crime declined slowly. The data even hold true at the neighborhood level – high lead concentrations correlate so well that you can overlay maps of crime rates over maps of lead concentrations and get an almost perfect fit.

Third, and probably most important, the data go beyond just these models. As Drum himself points out, ‘If econometric studies were all there was to the story of lead, you’d be justified in remaining skeptical no matter how good the statistics look.’ But the chemistry and neuroscience of lead gives us good reason to believe the connection. Decades of research has shown that lead poisoning causes significant and probably irreversible damage to the brain. Not only does lead degrade cognitive abilities and lower intelligence, but it also degrades a person’s ability to make decisions by damaging areas of the brain responsible for ‘emotional regulation, impulse control, attention, verbal reasoning and mental flexibility.’

So there you have it: the latest front in the battle against crime is chemistry.

If any of our readers have a neuroscience background, we would love to hear your thoughts on this.

There is a distinct intersection between two topics we focus on: incarcerated women and incarcerated juveniles. Each group has it’s own distinct issues, but young women in prison suffer the burden of both.

One troubling issue recently spotlighted by NPR is the state of health care for girls within the juvenile justice system. You see, the system is geared towards boys. Due to the simple differences in biology alone, this leaves vital needs unaddressed.

Up to 90 percent of these girls have experienced physical, sexual or emotional abuse, Pierce says.

Their health statistics are particularly grim: 41 percent have signs of vaginal injury consistent with sexual assault; up to a third have been or are currently pregnant; 8 percent have had positive skin tests for tuberculosis; and 30 percent need glasses but don’t have them, according to research from the National Girls Health and Justice Institute.

Do we really need to discuss why it is important to get proper treatment for health issues related to sexual assault? Or pregnancy? How about this additional finding that puts another vital piece of information on the table (also from the NPR report):

[Psychologist Leslie] Acoca argues it’s worth it to make the time. Her research has yielded a surprising finding: Poor physical health seems to increase girls’ risk of recidivism. In other words, girls who have health problems are more likely to reoffend and end up back in the criminal justice system.

This is not only a matter of health; it is a matter of reducing repeat offenses. I would say that should be enough to prioritize it for anyone.

The NPR piece does offer one potential solution: a new screening questionaire. By taking detailed info about health problems specific to women, care can be improved drastically. In addition, incoming inmates who might not be forthcoming in a not-so-public verbal interview have a higher chance of reporting health issues on a printed questionaire.

Those working in the system call it untenable due to the lack of staffing. In response I would question how many of those few staff hours are dedicated to dealing with the fallout from unreported problems.

In order to provide effective treatment and programming to youth with behavioral health needs, juvenile justice authorities and their partners must be equipped to quickly identify individuals who may have these needs, make referrals for full assessments and appropriate services, and provide services both while the youths are in custody and during the reentry process. Presenters focus on the use of assessment tools and other treatment needs, and matching youths to appropriate and effective programs and supports.

Valerie Williams, Research Instructor and Co-Director, National Youth Screening and Assessment Project, Center for Mental Health Services Research, Department of Psychiatry, University of Massachusetts Medical School

Health care is an issue that has been all over the news for quite some time now. Unfortunately the health care of the youthful and incarcerated has often been overlooked as Washington attempts to implement new programs for the voting masses.

Not anymore. The American Academy of Pediatrics’ Committee on Adolescence has released a policy statement, the first update in a decade to the Health Care for Youth in the Juvenile Justice System. It finds that incarcerated youth are at high-risk for health issues, physical, mental and developmental. Here is the statement’s abstract for an overview:

Youth in the juvenile correctional system are a high-risk population who, in many cases, have unmet physical, developmental, and mental health needs. Multiple studies have found that some of these health issues occur at higher rates than in the general adolescent population. Although some youth in the juvenile justice system have interfaced with health care providers in their community on a regular basis, othershave had inconsistent or nonexistent care. The health needs of these youth are commonly identiﬁed when they are admitted to a juvenile custodial facility. Pediatricians and other health care providers play an important role in the care of these youth, and continuity between the community and the correctional facility is crucial. This policy statement provides an overview of the health needs of youth in the juvenile correctional system, including existing resources and standards forcare, ﬁnancing of health care within correctional facilities, and evidence-based interventions. Recommendations are provided for the provision of health care services to youth in the juvenile correctionalsystem as well as speciﬁc areas for advocacy efforts. Pediatrics 2011; 128:1219–123

According to the report nearly 11 million juveniles across the nation were arrested in 2008. Not all of them suffered detention, long or short term, but the average stay behind bars for the ones who did was 65 days as of 2006. Of those in custody, 80% remained in detention for at least 30 days and 57% for at least 90 days. All of them requiring health care of some sort. Unfortunately that health care often does not appear, and when it does it is often substandard.

‘We wanted to advocate for these youth to have the same level and standards of care as non-incarcerated youth in the community,” the report’s lead author, Dr. Paula Braverman, Director of Community Programs at the Cincinatti Children’s Hospital Medical Center said in an email. She said the Committee on Adolescence also “outlined specific recommendations which included the training and skill of the health care providers.’

All too often health care in detention facilities is administered by people with insufficient training in the subject. She also touched on a subject that we here at HumaneExposures find to be vital:

‘We also wanted to highlight some areas for advocacy,’ she said, ‘including the need for adequate levels of funding to provide for the medical, behavioral health and educational needs of these youth.’ Equally important, she said, are intervention programs in the community ‘that address the risk and protective factors related to involvement in the juvenile justice system.’

Once more we have support for the idea that intervention, rehabilitation, and education are vital pieces to the puzzle. With such a preponderance of evidence that these tactics work there is still resistance to them. Hopefully as we see more high stature organizations like The American Academy of Pediatrics weigh in on the subject we will see the needed shift in public opinion.

HUMANE EXPOSURES explores the quality of daytime TV for young mothers with children at home, or for children and teens coming home from school and turning on TV as they have a break between school and homework. Or are all kids in afternoon sports?

The Doctors, CBS daytime one-hour show, had topics about “mental orgasm,” “vaginal discharge,” “swamp butt,” “anal sex,” “going gray down there,” and other embarrassing, personal, female issues that children and teenagers coming home from school, grabbing a snack and turning on the tube, do not need to see, hear about, become aware of, or add to other inappropriate viewing on daytime TV. Is this valued information for young mothers to view? Is this what we want young mothers and their mothers to talk about as critical issues of today? This show airs in San Diego from 4:00-5:00 p.m. opposite Oprah.

An oft recurring theme on the HUMANE EXPOSURES blog is the effect of parenting and environment on the early development of children. Studies of runaways and incarcerated juveniles show a correlation between those early years and the eventual path that the child takes as an adult.

Think of how frequently the topic of abuse or a neglect-ridden childhood comes up in court and in the studies of repeat offenders. Consider the personal narratives of the homeless and how much of a recurring theme these issues are in their plight.

Enter Notre Dame psychology professor Darcia Narvaez who has helmed a recent group of studies that confirm earlier work done in the field. The results suggest that children who get more physical affection during infancy turn out to be kinder, smarter, and more caring about others.

Maia Szalavitz, a journalist and author of some renown in this field, noted Narvaez’ work in her recent column on Time Magazine‘s Healthland blog:

Narvaez, who will present her findings at a conference in early October, conducted three separate studies. The first compared parenting practices in the U.S. and China. Another followed a large sample of children of teen mothers who were involved in a child abuse–prevention project, and compared outcomes of various types of early parenting practices. The third examined how parents of 3-year-olds behaved toward their children.

So we have a nice broad base to start from, that’s good. The variety of studies does give us confidence about the veracity of the findings. Szalavitz writes:

All three studies suggested the same thing: children who are shown more affection early in life reap big benefits. Researchers found that kids who were held more by their parents, whose cries received quick responses in infancy and who were disciplined without corporal punishment were more empathic — that is, they were better able to understand the minds of others — later in life.

Later in the column, Narvaez neatly sums up the findings:

‘What’s been studied most is responsivity,’ [Narvaez] says, referring to the way parents respond to their babies and act accordingly, for example, noticing when they are about to cry and reacting appropriately to subtle positive and negative signals about what they want. ‘[Responsivity] is clearly linked with moral development. It helps foster an agreeable personality, early conscience development and greater prosocial behavior.”

Even behavioral research on rats bears this out. Rats raised by neglectful mothers tend to be not as fast, smart, or social as their more doted-on counterparts.

Research like this is highly important. If we are ever to cure the society’s ills, we need to know where our efforts need to be applied. Work like this confirms our already existent ideas about how crucial early development is when looked at in the context of its impact on later life.

We would also advise checking out more work by Maia Szalavitz. She is a journalist who covers health, science and public policy. She is a co-author, with leading child trauma expert Bruce D. Perry, M.D., Ph.D., of Born for Love: Why Empathy is Essential– and Endangered, (Morrow, 2010). They previously co-authored The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007). Her work in the field of journalism runs the gamut from The New York Times and The Washington Post to New Scientist and O, The Oprah Magazine, among other major publications.

When you hear about the homeless issues in the media, it often seems that the solutions being attempted are usually centered on housing. While, at first glance, this seems the most efficient approach, it is hardly a panacea. In order to maintain a roof over their heads, the homeless need other things. Sometimes it is discipline, sometimes it is substance-abuse treatment, sometimes it is a matter of helping them become employable.

One thing that is always central is that the issues of health and self-esteem seem to play a much more major role in rehabilitating the homeless than providing housing does. Just read some of the personal narratives contained in downTownUSA, and you will notice how frequently the homeless choose the streets over shelter.

One promising approach to solving these issues is Back On My Feet (BOMF), which started in Philadelphia and is in the process of going national. BOMF acts as a support group for the homeless, geared towards developing their discipline, health and self-esteem, so that they can get their lives back in order. How does it do this? Would you believe it, by running? Here is an excerpt from the description on the BOMF website:

We do not provide food or shelter, but instead provide a community that embraces equality, respect, discipline, teamwork and leadership. Our organization consists of much more than just running: our members participate in a comprehensive program that offers connections to job training, employment and housing. Those benefits are earned by maintaining 90 percent attendance at the morning runs three days a week for our six to nine month program.

As anyone who has ever tried a regular exercise regimen can attest, it takes a lot of discipline to go out and run every morning. Still, using running as a means of helping the homeless is not exactly the most intuitive approach.

Let’s take a look at things firsthand. Marisol Bello, a writer for USA Today, has a great article about the organization that includes this video, which contains interviews with the program operators and the participants:

In the text portion of Bello’s report we get some of the details on exactly how the program renders aid to its participants:

Those who show up 90% of the time in the first 30 days get a stipend of up to $1,250 to be used for rental deposits on apartments or to pay for furniture, classes, transit cards or clothes for a job. The stipend goes to the merchants, not the participant. The money comes from corporate and private donations, and shoe stores donate the sneakers.

More than half of those who have started the program are still participating or have left because they found jobs or homes, the group says.

Having that information on hand makes it much easier to see how useful BOMF can be. The stipend allows the participants to gradually ease back into society. If the group’s claims about the number of participants who have found homes and employment are correct, this looks like a winner.

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Mission Statement

To take a penetrating look at the needs and challenges of society's disenfranchised—the denizens of our streets, the emotionally and physically incarcerated, children in juvenile hall and in unsettled homes. To encourage public awareness of the causes that underlie the destructive cycles plaguing these populations, including the abuse and neglect that cycle through generations; to underscore that the economic burden on society is lightened when these issues are addressed. To use photography, books, film, education, and advocacy to increase understanding and engender humane response.